Poor cervical proprioception as a risk factor for concussion in professional male rugby union players

T Farley; E Barry; K Bester; A Barbero; J Thoroughgood; A De Medici; R Sylvester; M G Wilson

doi:10.1016/j.ptsp.2022.03.010

Poor cervical proprioception as a risk factor for concussion in professional male rugby union players

Phys Ther Sport. 2022 May:55:211-217. doi: 10.1016/j.ptsp.2022.03.010. Epub 2022 Apr 4.

Authors

T Farley¹, E Barry², K Bester³, A Barbero³, J Thoroughgood³, A De Medici³, R Sylvester⁴, M G Wilson⁵

Affiliations

¹ Institute of Sport, Exercise and Health (ISEH), University College London, London, UK; Division of Surgery and Interventional Science, University College London, London, UK. Electronic address: t.farley@ucl.ac.uk.
² Georgia Rugby Federation, Tbilisi, Georgia; Division of Surgery and Interventional Science, University College London, London, UK.
³ Division of Surgery and Interventional Science, University College London, London, UK.
⁴ Institute of Sport, Exercise and Health (ISEH), University College London, London, UK; National Hospital for Neurology and Neurosurgery, London, UK.
⁵ Institute of Sport, Exercise and Health (ISEH), University College London, London, UK; Division of Surgery and Interventional Science, University College London, London, UK.

PMID: 35526515
DOI: 10.1016/j.ptsp.2022.03.010

Abstract

Background: Concussion is one of the most common injuries in male professional Rugby Union ('rugby') and accounts for significant time loss from training and competition. Despite the most recent Concussion in Sport Group consensus statement recommending a focus on the identification of modifiable risk factors, limited evidence for their existence is available.

Objective: To investigate the association between cervical proprioception and concussion incidence in a group of professional male rugby players over the course of a full season.

Methods: 165 players were assessed at pre-, mid- and end of season time points using the Cervical Joint Position Error Test (CJPET). Associations with diagnosed concussion injuries are presented as incidence rate ratios with 95% confidence intervals. We present the Incidence Rate Ratios (IRR) for a 10% increase in each variable and compared results against concussion using match minutes to account for risk exposure.

Results: During the study period, 45 concussions were incurred by 44 players [or 19.7 concussions per 1000 player-match hours]. There was a significant association between right rotation repositioning error and concussion, with a 5% increase in concussion rate for each 10% increase in gross right rotation error (P = 0.021).

Conclusion: Poor gross right rotation repositioning error is a modifiable intrinsic risk factor for concussion in professional male rugby players. Interventions to improve proprioceptive function may act as an effective method for reducing concussion incidence in this population.

Keywords: Cervical spine; Concussion; Proprioception; Risk factor; Rugby.

MeSH terms

Athletic Injuries* / epidemiology
Brain Concussion* / diagnosis
Brain Concussion* / epidemiology
Football* / injuries
Humans
Incidence
Male
Proprioception
Risk Factors
Rugby